Submucosal Versus Intramuscular Dexamethasone for Reduction of Postoperative Edema Following 3rd Molar Surgery

Abstract

Introduction:

Post-operative edema is a frequent complication following third molar surgery, leading to patient discomfort, delayed recovery, and increased risk of infection. Corticosteroids, particularly dexamethasone, are commonly used to reduce inflammation and edema. However, the optimal route of administration (submucosal versus intramuscular) remains a topic of debate. This study aims to compare the efficacy of submucosal versus intramuscular dexamethasone in reducing postoperative edema following third molar extractions.

Methodology:

A prospective, randomized controlled trial was conducted with 60 patients undergoing third molar extraction. Patients were randomly assigned to receive either 8 mg of dexamethasone via intramuscular injection (Group A) or submucosal injection (Group B). Linear measurements of edema were taken at 7 th postoperative taken using a caliper.

Results:

Both groups experienced a significant reduction in post-operative edema, with faster reduction observed in the submucosal group. The mean edema reduction at 72 hours was greater in Group B (submucosal). Patient satisfaction was higher in the submucosal group, with 80% of patients reporting a satisfactory postoperative experience compared to 60% in the intramuscular group.

Discussion:

The results suggest that submucosal administration of dexamethasone provides a faster and more effective reduction in post-operative edema and trismus compared to the intramuscular route. The localized effect of the submucosal injection may contribute to its faster action. These findings align with previous studies suggesting that direct delivery of dexamethasone to the surgical site may provide superior clinical outcomes. However, further studies with larger sample sizes and longer follow-up are needed to confirm these findings.

Conclusion:

Submucosal dexamethasone appears to be more effective than intramuscular dexamethasone in reducing postoperative edema and improving trismus following third molar surgery. Given the faster resolution of swelling and greater patient satisfaction, submucosal administration may be the preferred method for managing post-operative inflammation in dental surgeries.